ATTORNEY OR PARTY WITHOUT ATTORNEY (Name, Slate Bar number, and address): FOR COURT USE ONLY TELEPHONE NO.: EMAIL ADDRESS (Optional): ATTORNEY FOR (Name): FAX NO. (Optional): SUPERIOR COURT OF CALIFORNIA, COUNTY OF SAN DIEGO CENTRAL DIVISION, JUVENILE COURT, 2851 MEADOW LARK DR., SAN DIEGO, CA 92123 NORTH COUNTY DIVISION, 325 S. MELROSE DR., SUITE 130, VISTA, CA 92081 IN THE MATTER OF DATE OF BIRTH A MINOR CASE NUMBER CITATION FOR ADOPTION THE PEOPLE OF THE STATE OF CALIFORNIA To (name): You are advised that you are required to appear in the Superior Court of California, County of San Diego, on at a.m. p.m. in Department , at the court location indicated above, to show cause why the , court should not adjudge the adoption of the minor child, by the petitioner, . It is alleged that the other birth parent has been awarded custody of the child by judicial order or has custody by agreement of both parents. It is further alleged that you have, for a period of one year, willfully failed to communicate with and to pay for the care, support, and education of the child when able to do so. If you wish to seek the advice of an attorney in this matter, you should do so promptly so that your pleading, if any, may be filed on time. Clerk of the Superior Court Date: by , Deputy This citation was called in open court at the date and time noted above with without response. Clerk of the Superior Court Date: by , Deputy SDSC JUV-170 (Rev. 9/16) Mandatory Form CITATION FOR ADOPTION (See reverse side for Proof of Service) Fam. Code § 8604(b) American LegalNet, Inc. www.FormsWorkFlow.com Page 1 of 2 MINOR'S NAME CASE NUMBER PROOF OF SERVICE OF CITATION (ADOPTION) (Use separate proof of service for each person served) 1. I served: the person cited (name): other person (name and title/relationship to person cited): with the citation; the adoption request; other: Service was: a. Hand-delivered to a: to (address) home business on (date) at (time) b. Mailed to a: to (address) home business on (date) from (place) 2. Manner of service: a. b. Personal Service by personally delivering copies (Code Civ. Proc. § 415.10). Substituted service on natural person, minor, incompetent or candidate by leaving copies at the dwelling house usual place of abode usual place of business of the person cited in the presence of (name) , who was informed of the general nature of the papers, and thereafter by mailing by first-class mail, postage prepaid, copies to the person cited at the place where the copies were left (Code Civ. Proc, § 415.20(b)). (Attach separate declaration or affidavit stating acts relied on to establish reasonable diligence in first attempting personal service.) Mail and acknowledgment service by mailing by first-class mail copies to the person cited together with two copies of the Notice and Acknowledgment of Receipt (JC Form #POS-015) and a return envelope, postage prepaid, addressed to the sender (Civ. Code Proc. § 415.30). (Attach completed Notice and Acknowledgment of Receipt form.) Return receipt requested mail service by mailing to address outside California, with return receipt requested, copies to the person cited (Code Civ. Proc. § 415.40). (Attach signed return receipt or other evidence of actual delivery to the person served) Other-Code Civ. Proc. §§ 413.10 & 413.30 (Attach separate page if necessary): c. d. e. Additional page is attached. 3. At the time of service I was at least 18 years of age and not a party to this case. 4. Fee for service: $ 5. Name, address, and telephone number of person serving: , who is: a. b. not a registered California process server (Code Civ. Proc. § 417.40) and registered in (county name): number: c. a California sheriff (title): for (county name): exempt (Bus. & Prof. Code § 22350) I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct. Date: Type or print name SDSC JUV-170 (Rev. 9/16) Mandatory Form Signature PROOF OF SERVICE OF CITATION (ADOPTION) American LegalNet, Inc. www.FormsWorkFlow.com Page 2 of 2